IMM-INSERM Doctors Exchange Programme

Sara Gonçalves, the first doctor to be selected for the IMM-INSERM doctors exchange programme
“I believe that scientific research is a fundamental pillar of modern medicineSara Gonçalves is a doctor and over the next two years she will conduct a research project at the French National Institute of Health and Medical Research (INSERM). She is the first physician of the Institute of Molecular Medicine/Academic Medical Centre of Lisbon to be selected for the programme “Poste d’accueil”, an INSERM programme to bring doctors into research. This exchange is part of the cooperation protocol in clinical research agreed between the Institute of Molecular Medicine (IMMM) and the INSERM in July 2010.

This protocol also includes the joint organization of international workshops on state-of-the-art scientific and technological topics and guidance for medical students. The “Poste d’accueil” programme will have a new edition in 2012, and those interested in participating should contact the IMM coordinator for advanced training, Inês Crisóstomo (icrisostomo@fm.ul.pt), from now on.

Below is the testimonial of Sara Gonçalves, in an interview conducted by email.

What is your professional background and why did you decide to apply for this research exchange?

I concluded my medical degree at the Faculty of Medicine of Lisbon in 2002 and the Additional Internship at the Nephrology and Renal Transplantation Unit of Santa Maria Hospital. During the Internship I had the opportunity to participate in several clinical research projects, namely in the areas of diabetic nephropathy and acute kidney injury. In 2009 I carried out an optional internship in basic research applied to Nephrology in the Experimental Nephrology Laboratory of Fundación Jiménez Diaz, in Madrid.

This was an extremely enriching experience that showed me the importance of communication between science and medical practice. These experiences motivated me to seek a training programme that would enable me, in future, to have a career with a strong research component associated to clinical practice. The exchange programme between the Institute of Molecular Medicine (IMM) and the Institut National de la Santé et de la Recherche Médicale (INSERM) was the possibility to start this path in the best way, supervised by experienced researchers, at an internationally renowned research centre in Nephrology and with the chance of continuing further research at the Academic Medical Centre of Lisbon (CAML).

You are the first physician to be selected for this exchange programme. How did the application process go?

At this point I must say that Dr. Inês Crisóstomo offered excellent support during the application stage. The acceptance of my participation in the programme by my Director, Dr. António Gomes da Costa, was equally important.

The first step was to identify the research units at INSERM that best suited my profile and the type of project that I was interested in developing. Later, I contacted these units to ascertain their willingness to host me and to outline the project. Contact should be as timely as possible to allow a broad knowledge of the team who will receive us, the preparation of a coherent research project and connection with the research structures at IMM.

Applications go through a selection process. If accepted, it is necessary to attend an interview at the headquarters of INSERM, to introduce the applicant and present the project to be conducted. This was perhaps the stage I was most anxious about, but the end result was positive, thankfully.

What project will you be conducting over the next two years at INSERM, in France?

This project aims to identify the micro-RNAs that contribute to the normal functioning of podocytes and explore new genetic pathways that contribute to glomerular dysfunction in the context of ageing and kidney diseases. Micro-RNAs are non-coding RNAs responsible for post-transcriptional gene regulation. They are involved in multiple physiopathological processes and recently they have also been implicated in several renal diseases. However, the role of micro-RNAs at the level of podocytes, which are key cells in the process of kidney ageing and nephrotic syndrome, has not been established yet. In order to identify the micro-RNAs involved in the process we will use a new podocyte isolation technique on ageing and nephrotic syndrome animal models. The identified micro-RNAs will also be evaluated as potential urinary biomarkers in animal and human models, with the results validated in kidney biopsies in elderly patients and in patients with nephrotic syndrome.

Why is it important for you, as a doctor, to carry out scientific research?

I believe that scientific research is a fundamental pillar of modern medicine. Research fosters a critical and inquisitive mind, which is vital for medical practice. On the other hand, the emphasis placed on the physiopathology of diseases allows us to have a better understanding of them and of the rationale behind the corresponding therapy, which is an unquestionable asset in the approach to the pathologies. Recently, a lot of emphasis has been given to the possibility of connecting Basic Science with clinical practice, and the intention is to maintain a bi-directional flow between the two areas. Accordingly, the problems that arise in medical practice are the start of subsequent basic research. Conversely, the physiopathological knowledge acquired flows over to the clinical part as new biomarkers or therapeutic goals. Thus, I consider that the clinical part is simultaneously a point of departure and of arrival, with Basic Science acting as a key intermediate point that enables us to explore new paths.

How important is this exchange for your career?

I think that this exchange is a unique opportunity to take the first steps towards pursuing a career with a strong component of translational research in the field of Nephrology.

The possibility of continuing further research in collaboration with the micro-RNAs group of the Cell Biology Unit of IMM is certainly another plus, as it allows me to continue the path already begun. I also intend to apply to CAML’s doctoral programme, and be part of the research strands that will result from this project.

Despite all the practical challenges that may arise from the fact that my basic training is mostly clinical and not laboratorial, I hope that the advantages of being able to contribute with my medical experience will also stand out, and that this interaction leads to solid development.